In this project we seek to utilize our successful experience in computer-assisted patient education in order to develop a comprehensive informatics framework for rapid adaptation and dissemination of Comparative Effectiveness Research (CER) products tailored to different categories of health consumers including difficult-to-reach patients. We will refine our current interactive education platform to implement and test a novel system for individualized continuous patient education (iCOPE). The iCOPE platform will be specifically designed to support rapid adaptation, customization, and dissemination of the CER products to the difficult-to-reach populations. The iCOPE platform will implement universal means for customized delivery of CER information in the format of interactive self-paced educational modules, quick "question &answer" guides, and interactive decision aids. In addition, the iCOPE platform will support the innovative concept of continuous patient health education by providing patients with easy access to the interactive CER updates via web, MP3 players and phone-based interactive voice response (IVR) technology. Though iCOPE will be designed to support the whole spectrum of CER products, in this project we will focus on the Comparative Effectiveness Research Summary Guide (CERSG) entitled "Pills for Type 2 Diabetes." We will assess the impact of the iCOPE platform on CERSG knowledge in a randomized clinical trial (RCT) separately in hospital, primary care and community environments. For this purpose, overall 318 elderly with diabetes will be enrolled and followed for 6 months. The comparison will be made with control group using printed versions of the CERSG. The following primary hypothesis will be tested in the RCT: Use of the iCOPE platform will be associated with improvement in CERSG knowledge in elderly at 6 month after the intervention. We will also investigate the impact of iCOPE on medication adherence, diabetes medication satisfaction, and HbA1c. The following secondary hypothesis will be evaluated: The iCOPE intervention will be associated with increase in CERSG acceptance, medication adherence self-efficacy, and positive impact on beliefs about taking diabetes medications. Cost analysis will be conducted to assess the direct costs of implementing the iCOPE intervention. PUBLIC HEALTH RELEVANCE: The aim of this study is development and evaluation of individualized continuous patient education (iCOPE) platform for adaptation and dissemination of Comparative Effectiveness Research (CER) products in difficult-to-reach populations. We will enroll 318 elderly with diabetes in a controlled clinical trial to evaluate the impact of iCOPE platform on patient knowledge of CER results, medication self-efficacy, adherence, health beliefs, and satisfaction with diabetes medications.